Abuse in Later Life

What is Abuse in Later Life?

Abuse in later life is physical, sexual, or psychological abuse, neglect, financial exploitation, or stalking of an adult age 50 years or older. In most cases, the victim is in an ongoing relationship (such as spouse, partner, family member, or caregiver) where society expects there to be a trusting, caring connection.Who is affected by abuse in later life?
Older victims are from a variety of racial and ethnic groups and all economic levels. Many older victims are active members of the community. Some older victims are frail and live with significant health issues, physical disabilities, and/or cognitive limitations. Females, males and those who don’t identify with a specific gender identity may be victims of abuse in later life.Who is perpetrating abuse in later life?
A significant portion of elder abuse is spouse or partner abuse. Most offenders are spouses, partners, family members, caregivers and other persons in a relationship where the victim and society expects compassion and caring. Sexual assault or stalking in later life may also be committed by strangers.How common is abuse in later life?
National incidence and prevalence data on abuse in later life do not exist, but two recent studies found that 7.6%-11% of people age 60 and older who can answer a phone and pass a basic dementia screen are victims of abuse, neglect, or exploitation. However, these studies cannot capture older people at greatest risk: those who live in facilities; who cannot answer or do not have a phone; are too scared to speak because an abuser is close by; or people with dementia.

What causes Abuse in Later Life?

Research indicates that power and control dynamics such as found with younger battered women often present in elder abuse cases. Greed is also a motivator in financial exploitation cases. Perpetrators will often strive to exert their power and control over victims so they can coerce or manipulate some benefit for themselves, such as money, a place to stay, access to prescription medication, or sexual gratification. These abusers often feel entitled to do whatever necessary to get what they want. They may financially exploit an older adult, feeling entitled to take a Social Security check or empty a bank account. In order to maintain power and control, these abusers typically use various coercive tactics including physical and psychological abuse and isolation. Abusers may intimidate their victims and prevent them from presorting the exploitation or abuse out of fear of retaliation. They may also lie and manipulate family members, friends, and professionals in order to hide or justify their behavior.

The National Clearinghouse on Abuse in Later Life Power and Control Wheel (pictured below) depicts the dynamics of abuse in later life and illustrates how abusive tactics, especially psychological and emotional abuse, reinforce power and control in these relationships making it difficult for victims/survivors to break free.

Additional factors
In a small number of cases, well intentioned caregivers are unable to provide care and an older adult is harmed unintentionally. Also, a small number of abusers cannot control their behavior due to a medical or mental health condition that manifests in aggressive, inappropriate, or violent behavior.

Theories that elder abuse is caused by caregiver stress, anger, substance abuse, or retaliation for previous child abuse have not been supported by research. Often these issues co-exist with abuse, neglect, or exploitation but do not cause abuse. These problems may need to be dealt with as separate issues. But resolving these problems rarely enhances victim safety or improves the quality of an older victim’s life.

Warning Signs

Behavioral indicators of potential abuse
Listed below are possible behavioral indicators of abuse by potential victims and abusers. Most or all of the forms need NOT be present for abuse to be occurring. One or two indicators may warrant further questioning and investigation.

Potential victim may exhibit some of the behaviors listed below.

Has repeated “accidental injuries.”

Appears isolated.

Says or hints at being afraid.

Considers or attempts suicide.

Has history of alcohol or drug abuse (including prescription drugs).

Presents as a “difficult” client.

Has vague, chronic, or non-specific complaints.

Is unable to follow through on treatment plan or medical care.

May miss appointments.

Delay seeking medical help.

Exhibits depression (mild or severe).

Evidence of effects of stress and trauma such as chronic pain and other illnesses.

Talks about the family member as if he/she is not there or not a person (dehumanizes).

Physically assaults or threatens violence against victim or worker.

Threats of suicide or homicide or both.

Threats of harassment.

Stalking.

Cancels older person’s appointments.

Sabotages older person’s efforts to attend appointments by refusing to provide transportation or some other excuse.

Takes the older person’s to different doctors, hospitals and pharmacies to cover up abuse.

Uses the legal system to harass the older person (e.g., mutual protective orders, making false charges).

Financially dependent on older adult.

How to Help

If you are concerned about your own safety or mistreatment:
If you recognize signs of mistreatment or abuse in your relationships, it is important to seek help. If you are in immediate danger, call a law enforcement emergency line such as 911. You may also benefit from speaking with an advocate about resources and support available to help you break free from the abuse. Advocates are specially trained to assist people with their safety concerns and help them to plan for a future free from violence. You can reach an advocate 24 hours a day, 7 days a week by calling the Alexandra House Helpline at 763-780-2330.

Advocates can help you to create a safety plan such as the one found here (NCALL safety plan). Many older victims of abuse also benefit from individual or group counseling, emergency housing, and medical or legal advocacy. Please visit our Abuse in Later Life page for a list of services Alexandra House can provide.

If you are concerned about an older adult who may be mistreated:
Talk to the older adult. Tell them you are concerned for their safety and that you are there to help. Let them know that domestic violence, sexual abuse, and elder abuse do not stop without some sort of outside intervention. Offer to accompany them to speak with an advocate at a domestic violence or sexual assault program or a social worker at an elder abuse agency.

Be part of their safety plan. A safety plan is created by the victim with the help of a professional. The intent is to plan for a victim’s safety needs before another violent episode erupts. If you believe they are in immediate danger, call 911.

Call Alexandra House’s 24-hour Helpline at 763-780-2330 for additional information and support specific to your concerns.

Do not do anything that further isolates, blames or discourages victims such as:

Telling the victim what to do (e.g., “you should leave immediately”)

Judging a victim who returns to an abusive relationship

Threatening to or ending services if a victim does not do what you want

Breaking confidentiality by sharing information with the abuser or other family members

Blaming the victim for the abuse (“if only you had tried harder or done this, the abuse might not have happened”)

Reporting abuse to the authorities without permission from the victim (unless mandated by law). If you are a mandated reporter, tell the victim what you are doing and why. Help the victim with safety planning or find someone who can.

Documenting opinions (he’s drunk and obnoxious” or “she’s hysterical and overreacting”). These statements are opinions and may not be accurate. However, they can be used against a victim in court.

Do not collude with the abuser and give him/her more power and control by:

Accepting excuses from the abuser and supporting the violence (“I can understand how much pressure you are under.” “These things happen.”)

Blaming drugs or alcohol, stress, anger, or mental illness for the abuse. Abusers must be held accountable for their actions before they will change their behavior.

Minimizing the potential danger to the victim or yourself if you offer help.

Do everything possible to give a victim a sense of hope by:

Believing the account of the abuse

Sharing that abuse can happen to anyone and the victim is not alone

Affirming that the victim is not to blame for the abuse

Planning for safety and/or seeking support from a professional to create a safety plan

Offering options and giving information about resources or finding someone who can

Allowing the victim to make decisions about next steps (returning power to the victim)

Keeping information shared by the victim confidential

Documenting the abuse with photographs, body maps, and victim statements

Additional Resources

Minnesota Adult Abuse Reporting Center
The Minnesota Adult Abuse Reporting Center provides a toll-free number mandated reporters and the general public can call to report suspected maltreatment of vulnerable adults. Reports will be promptly submitted to the appropriate investigative agencies. 844-880-1574

Minnesota Elder Justice Center
The mission of the Minnesota Elder Justice Center is to mobilize communities to prevent and alleviate abuse, neglect, and financial exploitation of elders and vulnerable adults. Their three immediate areas of focus are: public awareness, professional education and practice, and public policy. elderjusticemn.org

National Clearinghouse On Abuse In Later Life (NCALL)
NCALL’s mission is to eliminate abuse in later life. Through advocacy and education, NCALL strives to challenge and change the beliefs, policies, practices, and systems that allow abuse to occur and continue. NCALL also aims to improve victim safety by increasing the quality and availability of victim services and support. www.ncall.us

National Center On Elder Abuse (NCEA)
The NCEA is the place to turn to for up-to-date information regarding research, training, best practices, news and resources on elder abuse, neglect and exploitation. The Center provides information to policy makers, professionals in the elder justice field, and the public.www.ncea.aoa.gov